Claustrophobia

Claustrophobia, defined as an extreme fear of small enclosed spaces, is believed to be the primary reason why MRI patients have anxiety and are unable to complete their exam5,16,60. Like most phobias, claustrophobia may begin in childhood, with most cases becoming apparent by age 18, although there have been cases in which the onset of claustrophobia does​​ not occur until they have an MRI exam59,61. A person who suffers from claustrophobia fears they will become trapped in an enclosed space and they tend to have catastrophic thoughts or cognitions, which cause them to panic5. Panic begins when adrenaline floods into the bloodstream, putting the body on high alert. Your heart rate rises, which sends more blood to the muscles. Your breathing becomes fast and shallow, so you can take in more oxygen. Your blood sugar spikes and your senses become sharper37. Thus, once a person begins to panic, they start to experience physiological symptoms such as increased heart rate, a spike in blood sugar, and shortness of breath, which are the most prominent symptoms associated with claustrophobia5,26,62. When a person experiences respiratory distress, they begin to have cognitions that they will “suffocate and die”32, p.192. This is what happens to some patients in the MRI unit26. The fear of suffocation may cause the patient to feel they are suffering from “air hunger,” which is when the body gives a false alarm that it isn’t receiving enough oxygen5. The person then begins to breathe faster, which can lead to hyperventilation and, ultimately, a panic attack5,53. A good example of how a patient who is experiencing air hunger feels is how you may have felt while wearing a mask during the COVID-19 pandemic. After a long shift of continuously wearing a mask you feel the mask must come off right away lest you suffocate.

There are a variety of physiological symptoms that people experience with claustrophobia including:​​ 

Figure​​ 5.​​ Claustrophobia Symptoms62